Provider Demographics
NPI:1427328558
Name:EXCEL REHAB SERVICES
Entity type:Organization
Organization Name:EXCEL REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BINETT
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:305-389-1769
Mailing Address - Street 1:10031 PINES BLVD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6179
Mailing Address - Country:US
Mailing Address - Phone:305-389-1769
Mailing Address - Fax:954-441-4458
Practice Address - Street 1:10031 PINES BLVD
Practice Address - Street 2:SUITE 217
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6179
Practice Address - Country:US
Practice Address - Phone:305-389-1769
Practice Address - Fax:954-441-4458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4221225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1760453666Medicaid